The Effectiveness of Coping Strategies in the Latent First Stage of Labour: A Systematic Review

Abstract

Introduction: Coping strategies performed in labour or taught in pregnancy reduce women’s pain and anxiety, enhancing women’ self-efficacy. To identify which are the most appropriate coping strategies health care providers should implement to help women cope with a prolonged latent phase of labour. Materials and Methods: A systematic review was carried out during December 2018 on MEDLINE - Pubmed, CINAHL, Web of Science PsycINFO, and Scopus. All of the RCTs assessing the effects of coping strategies during the latent phase of labour on primiparous or nulliparous women aged 16 or above were included. We independently reviewed the selected studies and extracted data using predefined criteria including samples, interventions, timings and outcomes. Results: 3591 studies were identified, of which 8 met the inclusion criteria. Two main groups of coping strategies were found: Coping Strategies Performed in Labour (CSPL) or Coping Strategies Taught in Pregnancy (CSTP). The CSPL included manual or relaxation techniques delivered during labour, which were associated with a decrease of pain intensity and anxiety levels. The CSTP included educational interventions provided during the third trimester of pregnancy, which were aimed to improve women’s self-efficacy and knowledge about labour. Efficacy of educational interventions wasn’t consistent among all studies, but self-efficacy was higher in women educated on relaxation techniques, while pain was lower in women educated on both manual and relaxation techniques. Discussion: More high-quality research is needed regarding which groups of coping strategies is more effective, paying attention on the measurement tools, outcomes and health care providers involved.